People Diagnosed with Bipolar Disorder at Increased Risk for Parkinson’s

Increased Parkinson's risk could be related to lithium, antipsychotic, and antiepileptic drug use.

Peter Simons
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A new study in JAMA Neurology found that having a diagnosis of bipolar disorder more than triples the risk of a later Parkinson’s disease diagnosis. The researchers combined and analyzed data from seven previous studies for a total of 4,374,211 participants. The study was led by Joaquim Ferreira and Gonçalo Duarte at the University of Lisbon, Portugal.

In addition, the shorter-term studies (less than nine years until follow-up) found that people with a bipolar disorder diagnosis were more than five times as likely to develop Parkinson’s disease.

The primary features of Parkinson’s disease are loss of motor control, tremors, and slowed movement. It may also be accompanied by depression and cognitive problems. Drug-induced parkinsonism has been well-documented to affect at least 20% of people who take antipsychotic medications.

Photo Credit: Max Pixel

The researchers write that their results may also be due to the use of lithium, antipsychotics, and antiepileptics since they found it “particularly difficult” to exclude these confounds. They did not attempt to control for the use of these drugs, because they consider them “foundational” aspects of treatment. They assumed that every participant was taking at least one type of these drugs.

The researchers write that determining whether Parkinson’s disease is a side effect of commonly-prescribed medications is “a purely academic effort.”

In the current study, the researchers wanted to distinguish between idiopathic (unknown cause) Parkinson’s disease and drug-induced parkinsonism. Since the vastly increased risk of drug-induced parkinsonism is already known, they wanted to discover if the risk of idiopathic Parkinson’s disease was also increased in bipolar disorder. However, they acknowledge that drug-induced parkinsonism “is not clinically distinguishable from Parkinson’s disease.”

According to other studies, drug-induced parkinsonism is often misdiagnosed as idiopathic. The main distinction is that drug-induced parkinsonism generally progresses faster and has more cognitive effects, while idiopathic Parkinson’s disease progresses slower but has a more degenerative course. Drug-induced parkinsonism also tends not to respond to Levodopa, the primary drug used to treat the syndrome.

The researchers attempted to exclude diagnoses of drug-induced parkinsonism, although some of the included data did not distinguish between the two. If symptoms that were known to be drug-induced were included, the risk of parkinsonism would increase considerably. For instance, based on research into drug-induced effects, an additional 20% of the participants might have had parkinsonism symptoms.

The researchers hypothesized that bipolar disorder itself might lead to Parkinson’s disease since both syndromes are theorized to be disorders of the dopaminergic system. However, the researchers acknowledge that the cause of both disorders is unknown and that bipolar disorder itself “is not associated with overt evidence of neurodegeneration.”

The researchers write that Although the etiology of [bipolar disorder] has not been established, it is a multifactorial disorder with genetic and environmental factors playing an important role. Despite the pathophysiology of BD being uncertain, there is a putative role of the dopaminergic system.”

The researchers write that almost every participant with bipolar disorder in their study was taking some form of psychotropic medication associated with parkinsonism effects, and the researchers did not try to control for drug use. However, they still suggest that the development of Parkinson’s disease “may not be drug-induced.”

Ferreira and Duarte acknowledge that their study may create more questions than it answers:

These results may invite many questions from people with BD and their physicians. Are all subtypes of BD at an equal risk? Is the risk present even when the diagnosis is made at a young age? What are the roles of lithium and antipsychotics?

They write that they hope future research can address some of these concerns.

 

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Faustino, P. R., Duarte, G. S., Chendo, I., Caldas, A. C., Reimão, S., Fernandes, R. M. . . . & Ferreira, J. J. (2019). Risk of developing Parkinson’s disease in bipolar disorder: A systematic review and meta-analysis. JAMA Neurol. Published online, October 14, 2019. DOI:10.1001/jamaneurol.2019.3446 (Link)

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Peter Simons
MIA Research News Team: Peter Simons comes from a background in the humanities where he studied English, philosophy, and art. Now working on his PhD in Counseling Psychology, his recent research has focused on conflicts of interest in the psychopharmaceutical research literature, the use of antipsychotic medications in the treatment of depression, and the general philosophical and sociopolitical implications of psychiatric taxonomy in diagnosis and treatment.

18 COMMENTS

  1. “The researchers write that ‘Although the etiology of [bipolar disorder] has not been established, it is a multifactorial disorder with genetic and environmental factors playing an important role.'”

    How can Robert Whitaker’s website even publish this statement? Robert pointed out, quite convincingly, that the primary etiology of “bipolar” is the adverse effects of the antidepressants and ADHD drugs being misdiagnosed as “bipolar” in his book “Anatomy of an Epidemic.”

    https://www.alternet.org/2010/04/are_prozac_and_other_psychiatric_drugs_causing_the_astonishing_rise_of_mental_illness_in_america/

    Despite this disclaimer clearly included in the DSM-IV-TR of the time:

    “Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g., medication, electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder.”

    And his concern has been confirmed by MANY people who were thus misdiagnosed, and write on this website, myself being one of them. What was the unethical psychiatric industry’s response to Whitaker’s well researched findings? To take that disclaimer out of the DSM5, rather than to add the ADHD drugs to that disclaimer, which would have been the response of ethical “professionals.”

    My family learned decades ago that the antipsychotics create the Parkinson’s symptoms. My grandmother was quickly taken off the antipsychotic that she’d been improperly put on, and lived a healthy, happy, non-“psychotic,” non-“mentally ill” life, to the ripe old age of 94.

    But when ethical and honest people point out that the antipsychotics create the Parkinson symptoms to our unethical “mental health” workers today. They make incorrect assumptions, misdiagnose a person’s grandmother as “psychotic,” who they’ve never met, and who never was “psychotic.” I even have a note written by her former doctor to prove this. Then the “mental health” workers incorrectly assume a family history of their so called “mental illnesses,” despite this being incorrect. And then the “mental health” workers attempt to murder those family members who know the antipsychotics create the Parkinson symptoms.

    Nothing personal, but this entire blog sounds like double speak. The reality is “bipolar” is not a real disease.

    http://behaviorismandmentalhealth.com/2009/09/06/bipolar-disorder-is-not-an-illness/
    https://www.nimh.nih.gov/about/directors/thomas-insel/blog/2013/transforming-diagnosis.shtml

    But the “bipolar” treatments, particularly the neuroleptics/antipsychotics, do create the Parkinson symptoms. They also create “psychosis” and “hallucinations” (the positive symptoms of “schizophrenia”), via anticholinergic toxidrome poisoning.

    https://en.wikipedia.org/wiki/Toxidrome

    The antipsychotics/neuroleptics also create the negative symptoms of “schizophrenia,” via neuroleptic induced deficit syndrome.

    https://en.wikipedia.org/wiki/Neuroleptic-induced_deficit_syndrome

    Our so called “mental health” industry is an industry all about iatrogenic illness creation, not about real “genetic” illnesses. Wake up, DSM deluded “mental health” workers.

  2. I’ve often wondered about the potential for Parkinson’s disease to develop out of parkinsonism. I would suspect that the numbers of people diagnosed with bipolar disorder who develop Parkinson’s disease could be showing us just that.

    20 % + 20 % = 40 %, the research in the article above estimates run for the showing of symptoms of parkinsonism. I would suspect that, as neuroleptics are dopamine blockers, the numbers of neuroleptic users experiencing symptoms might be even higher than that, something like around, say, 100 %.

  3. “The researchers write that their results may also be due to the use of lithium, antipsychotics, and antiepileptics since they found it “particularly difficult” to exclude these confounds. They did not attempt to control for the use of these drugs, because they consider them “foundational” aspects of treatment. They assumed that every participant was taking at least one type of these drugs.”

    It’s hard to read this without feeling enraged. I developed Parkinsonism after taking Latuda. I started recovering pretty much immediately upon cessation and made significant progress even before the Lyme treatment. Thirty days of doxycycline combined with cessation of psychiatric neurotoxins have come close to restoring my previous level of cognitive and neurological functioning. These monsters at NIH would have let me continue to deteriorate and called it bipolar and PD. My heart aches for all the people in these studies who are allowed to continue to decline cognitively and having it blamed on the diseases of bipolar and PD. This is government sponsored propaganda against labeled and thus marginalized populations. It seems to still be perfectly okay to conduct these unethical experiments on anyone stigmatized as “crazy”, “mad”, “mentally ill”, etc.

    NIH researchers also misdiagnosed my mother with Sjogren’s Syndrome when she in fact had Lyme disease. Her results (likely combined with many others misdiagnosed and mistreated) confound study results and lead to continued mistreatment in the medical care system.

    Disgusting! Unethical! Barbaric! These are just a few of the words that come to mind about this study and these researchers, and frankly NIH researchers on the whole, given the history. It’s still seemingly staffed by Nazis and eugenics is alive and well.

  4. I also think the headline should read ‘People Treated for Bipolar Disorder at Increased Risk for Parkinson’s’. Because the researchers refuse to control for medication use, and because they assume virtually 100% of participants are taking these drugs, there absolutely has NOT been a correlation established between “bipolar disorder“ and Parkinson’s Disease, but it does in fact reinforce previous studies that have implicated these and other drugs in causing Parkinsonism. But don’t worry, we HAVE to poison the “mentally ill” for their own good. Meanwhile the sheep line up for slaughter calling for ever more of this mind-liberating “treatment”.

    A shot gun would be preferable to any more of that slow death.

      • My grandfather had Parkinson’s. I’m very familiar with the disease and recognized my own symptoms even in a state of severe cognitive decline.

        My grandfather’s case was idiopathic and due to exposure to agricultural strength pesticides. He supplemented his income as a musician by being a seasonal farm worker.

        Thankfully, we know what his exposure was as well as he’s from my moms side with no history of “mental illness” or “bipolar”.

        My father is the only person that brings a supposed history of “bipolar” which he wasn’t diagnosed with until after he started Prozac off label for weight control in 1988.

        NIH researchers tried very hard to recruit me for a study on Parkinson’s back around 2006. I eventually decided not to participate in the study due to how many psych drugs I was taking which I knew would confound results. The recruiters actually became quite hostile when I dropped out. Now I know why. I was the perfect guinea pig for their mad science!

        PD is caused by a lack of dopamine – exactly the conditions neuroleptic drugs create. They might as well have entitled their study “Inducing Parkinson’s by Drugging the Crazies!” They know exactly what they’re doing!

  5. Glad this is coming to the surface. Their should be a patient led panel that supervises all of this studies because clearly these folks have no idea of what they are doing clinically wise and are serarated from the real but a solid wall.
    The implications could be staggering.

  6. Woah. So not only can you you become bipolar from taking an antidepressant but you can get Parkinson’s from the bipolar meds??! They really suck at the whole recovery thing don’t they. It’s like the Molotov cocktail solution from the Good Place. They don’t solve the problem they just create new ones!